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Elvis Augustin



Male Patients with Breast Cancer Could Benefit From New Gene Discovery

A group of researchers from the The Cancer Reasearch Institute in London have discovered a new gene, which is believed to increase the risk of breast cancer in male patients by 50 per cent.

Dr Nick Orr, leader at the Breakthrough Breast Cancer Research Centre at The Institute of Cancer Research, London and his team observed the genetic codes of over 800 male patients with breast cancer. The study, one of the largest in the world, has revealed a link between mutations in one, particular gene and the debut of breast cancer in male patients. This discovery could help scientists develop new treatments for male patients with breast cancer.

Very little is known about the appearance of breast cancer in men because of the rareness of the disease. It is found more often in men with ages between 60 and 70, who were exposed to radiation or have a family history of breast cancer. Furthermore, male patients with high estrogen levels , who suffer from diseases like cirrhosis or Klinefelter’s syndrome are more likely to develop breast cancer than healthy patients.

Symptoms of breast cancer in men are very similar to those in women. The most common include lumps, changes of the nipple or breast skin and discharges of fluids from the nipple. The treatment is usually a mastectomy, followed by radiation, chemotherapy and hormone therapy.

Breast Cancer Male

The causes of breast cancer in males are yet to be found. Previous studies have shown that BRCA2 genes are responsible for more than 10 per cent of breast cancer cases. Furthermore, researchers have now discovered that besides BRCA2 genes, RAD51B genes, which are accountable for breast cancer in women patients, also play a major role in developing this disease men.

Dr Nick Orr, said that this study will help scientists develop new treatments for breast cancer patients. Moreover, it will help doctors anticipate if a patient is at risk of developing the disease later in life, based on a genetic investigation which will determine whether they have the cancer genes or not.

Dr Orr also said that a better understanding of the disease will come after finding more male patients with breast cancer genes. Additionally, researchers are very hopeful that these findings will lead to more information about how the disease works in women also.

The next step and the ultimate goal for the international research team is finding a way to prevent the disease, but the there is a long journey ahead of them, said Dr. Mikael Hartman, co-author at this study. To get there, they will have to find hundreds of cancer markers and genes which can be held responsible for the appearance of the disease. After identifying those markers, a personalized treatment, based on each patients’ genetic makeup could be developed.


Stress increases the risk for heart disease

The fact that stress affects health is a well-known. We already know that stress can lead to serious short or long-term health problems (heart disease, diabetes, depression, hair loss etc.). Now an European meta-analysis published in The Lancet, showed that patients undergoing stress at work have a higher risk of  heart attack than others.
Mika Kivimäki from University College London, the lead of the study, wanted to clarify  that the link between stress and coronary heart disease was made on the basis of published and unpublished reasearch. In addition, Kivimäki said that people under stress at work have a higher risk of heart attack as the first manifestation of coronary artery disease.

Stressful Situation

Stressful Situation

This research was done in collaboration with multiple centers in Europe, such as Denmark, Belgium, Finland, France, Netherlands, Sweden, and the UK. The study included nearly 200,000 patients who completed questionnaires on stress at work, the number of tasks they have to fulfill, the level of pression, freedom to make decisions etc. They were followed for a period of 7.5 years. The finding is not surprising because during the 7 years of follow-up there were over 2300 coronary heart disease or heart attack. Study participants who reported being stressed work had a 23% higher risk of heart attack as the first manifestation of coronary heart disease. Moreover, the risk remained the same even after there have been taken into account demographic characteristics such as age, gender, financial status.
The results of this meta-analysis draws red flags because cardiovascular disease is one of the most common diseases of the modern world. In addition, researchers believe that the risk of coronary heart disease may increase due to job insecurity and economic crisis.
Work stress is associated not only with heart disease but also with other conditions such as diabetes, depression, obesity, sexual dysfunction, hyperthyroidism, cancer and others. Stress triggers a series of changes designed to help the body cope with difficult situations. Stress activates the sympathetic nervous system and the adrenal gland to release adrenaline and noradrenaline. These neurotransmitters are part of the fight or flight response, which gives the body energy and power. Also, another hormone that ia associated with stress is cortisol, which is released by the adrenal gland. This hormone boost all catabolic processes in the body but also increases the blood sugar. It is not uncommon for a person to be diagnosed with diabetes during a stressful event at work or family.


 First evidence for genetic cause of Barrett’s oesophagus

A team of researchers led by Professor Janusz Jankowski of the Blizard Institute of Cell and Molecular Science at Queen Mary, University of London (UK), made new discoveries about Barrett’s esophagus. The study led by researchers uncovers information about the genetic cause of Barrett’s esophagus. The discovery made by researchers at the University of London is extremely valuable because so far the genetic cause of Barrett’s esophagus has not been much investigated. Moreover, the discovery may lead to the development of screening tests for those likely to develop the disease. Barrett’s esophagus is considered a premalignant condition that may progress to esophageal adenocarcinoma. Histologically, Barrett’s esophagus means intestinal metaplasia ofesophageal epithelium. In other words, the esophagus from intestinal metaplasia islands appear.

Barrett's oesophagus

Barrett’s oesophagus

Causes of Barrett’s esophagus are not fully known. Barrett’s esophagus is most commonly associated with esophageal reflux disease. The more severe are the reflux symptoms, the risk of Barrett’s esophagus is greater. It should be noted that there are situations when Barrett esophagus is congenital. Hypothesis of a genetic cause has been taken into account because not all patients with severe esophagitis develop Barrett’s esophagus.

Barrett’s esophagus symptoms are similar to those given by esophageal reflux disease. In other words, patients have heartburn, that is burning sensation in the chest. It can occur also acid regurgitation  or other less common symptoms such as salivation, dysphagia (difficulty swallowing), odynophagia (painful swallowing), weight loss, anemia and others. Usually patients with such symptoms have incompetent lower esophageal sphincter, which causes stomach acid content into the esophagus. Esophageal epithelium is attacked by gastric acidity and thereby burning, ie heartburn.
The team led by Professor Janusz Jankowski analyzed the genomes of 1,800 patients with Barrett’s esophagus to find a genetic component to this disease. They investigated 660,000 genetic variations and found variations in the sequence variations of single nucleotides (which make up DNA ) in two chromosomes: 6p21 and 16q24. To ensure that the two SNPs (single nucleotide polymorphisms) are the those implied in Barrett’s esophagus, they verified the finding in approximately 4500 patients.
Professor Jankowski said this is the first time that a study shows a genetic link to Barrett’s esophagus. He added that with this discovery reflux disease patients can make screening tests to see if they are at risk of developing Barrett’s esophagus. 30% of the Western population has reflux disease and 10-20% of them develop  Barrett’s esophagus, Professor Jankowski said. He also has completed the discovery of a genetic cause can be the basis for targeted therapies in the treatment of Barrett’s esophagus.


Hepatitis C High Viral Load Patients May Benefit From Telaprevir

Researchers found that telaprevir in combination with peginterferon and ribavirin help patients with hepatitis C. Telaprevir is a virostatic drug that inhibits viral replication.

Hepatitis C can lead to liver failure and even hepatocellular cancer. C virus infection can be transmitted through blood transfusions, sexual intercourse, needle pricks, organ transplants, body piercing, etc.. In the first phase C virus infection is asymptomatic, but gradually nonspecific symptoms such as fatigue occur. There are cases in which C virus infection is manifested by acute symptoms such as nausea, joint pain, muscle pain, etc.. Sometimes jaundice occurs. Some of those infected with the virus C eliminate the infection, some are healthy carriers and some become chronic carriers. Of the latter, about 30% develop cirrhosis and hepatocellular cancer. Cirrhosis brings some complications such as portal hypertension and esophageal varices. The main risk is rupture of esophageal varices with the appearance of upper gastrointestinal bleeding . In addition to this complication, which can be fatal sometimes, there are also other consequences such as bruising, bleeding, endocrine disorders, portal encephalopathy etc. The only way to prevent virus C infection is to increase hygiene measures and halt the transmission because there is no vaccine against C available yet.



Studies by researchers at the Institute for Quality and Efficiency in Health Care (IQWiG) wanted to show what is the effectiveness of telaprevir when treatming viral hepatitis C. They compared the effects of several groups of patients treated with standard therapy (peginterferon and ribavirin) or  with triple therapy, ie peginterferon, ribavirin and telaprevir. The results were different depending on the group of patients and depending on outcome (mortality, morbidity, etc.). Telaprevir efficacy studies were performed on several groups of patients. The studies were conducted in patients with high viral load, patients who already had cirrhosis or not. The findings were different for different groups of patients. For example, it was found that telaprevir has an added benefit to the patients with high viral load, but without cirrhosis. Also, the researchers also found that telaprevir bring added benefice in patients without cirrhosis and in non-responders cirrhosis patients.

However, in patients without cirrhosis it was found that telaprevir has no benefit and can even cause some side effects, such as rash and anemia. It should be noted however that these adverse effects were considered as not serious and were not a restriction for patients with high viral load. In addition, for patients without cirrhosis and low viral load, triple therapy had no benefit compared with standard therapy (peginterferon and ribavirin).


Childhood Bacterial Meningitis Linked To Other Health Problems Later In Life

Bacterial meningitis has long-lasting effects on the nervous system, according to a study by researchers from the UCL Institute of Child Health. According to the research published in The Lancet Neurology, 1 in 3 children who suffered from bacterial meningitis during their childhood are prone to other health problems later in life. The study, led by Professor Russell Viner at the UCL Institute of Child Health, is the first of its kind to analyze the long-term effects of meningococcal disease.

Long-term effects of bacterial meningitis refers more to mental health problems. Bacterial meningitis has an effect not only on short-memory and long-lasting, but also on behavior. It seems that 1 in 5 children have behavioral disorders, that is anxiety or other behavioural problems. Other long-term effects of meningitis were those related to hearing. The researchers found that children who suffered from meningitis were 5 times more likely to have hearing disorders. In addition, 2.4% of them required a cochlear implant due to bilateral hearing impairment.

Furthermore, it was also found that children who suffered from bacterial meningitis were five more likely to have learning and communication problems. These children have a low borderline IQ. In addition, they have problems in terms of the ability to organize and plan, especially when advancing the educational level, from primary to secondary school. Meningitis is inflammation of the meninges, the membrane that is covering the brain and spinal cord, and can be life-threatening. Therefore, it is a medical emergency. Mortality was very high before antibiotics era, but even nowadays mortality remains high, approximately 25%. Meningitis is usually caused by bacteria, viruses, fungi or parasites. Bacterial meningitis is most often caused by bacteria that Streptococcus, Haemophilus, Neisseria and Staphylococcus meningitis. These microorganisms reach  the nervous system through bloodstream from other parts of the body and causes irritation of the meninges. Bacterial meningitis is usually located at the dorsum of the brain, but when it is caused by fungi, it can be located at the base of the brain. Meningitis may be fatal because it can cause various complications such as abscesses, ventriculitis, empyema, etc..

Bacterial meningitis affects about 3,500 people in the UK every year, and half of them are children. Newborns have the highest risk of developing meningitis. Apart from newborns, there has been an increased incidence in people aged over 60 years. Classic symptoms of meningitis are discomfort on neck flexion, photophobia and headache. There may be also present signs of infection, such as otitis, pneumonia, mastoiditis etc. In children, signs of meningitis are bulging fontanelle, paradoxical irritability, hypotonia, etc..


Cluster Headache

Cluster headache is a primary neurovascular disorder, which is characterized by sever unilateral headache. Doctors, scientists and patients have described the pain from cluster headache as the most intense pain a human can endure, worse than child birth or a broken bone.

Cluster headache has been described since the seventeenth century, when it was reported the cyclical, unilaterally and daily pattern of the headache, but Kunkle and his colleagues were the ones who mentioned the particular character of the disease: clusters of attacks that succeed in a very dense temporal sequence and then disappear. For a period of time, it was considered that the disease belongs to the class of vascular migraines, but the International Headache Society (IHS) reclassified cluster headache as a single entity, different from migraine.

Cluster headache prevalence is much lower than other forms of headache, being estimated 0.4% in men and 0.08% in women. The disease is more common in men, with a male-to-female ratio of 3:1.

Cluster Headache

Cluster Headache

Cluster Headache Symptoms

The International Headache Society (IHS) classifies cluster headache according to duration in episodic and in chronic form. Episodic cluster headache occurs in periods lasting from 7 days to 1 year; cluster attacks are separated by pain-free intervals lasting at least 2 weeks. In the chronic form of the disease, headaches attacks are recurrent and  occur continuously for periods of time longer than one year, with short remission, less than 14 days or with no remission.

The disease affects mostly males and the average age of onset is between 27 and 31 years. Recent studies suggest that in cluster headache pathogenesis, genetic factors are involved.

Cluster term refers to the disease pattern characterized by an agglomeration of attacks that occur in a dense succession of time and then suddenly disappear for varying periods of time.

Average frequency of painful attacks is 1 to 3 per day, but the number of attacks may increase to 15. An active disease cycle may last between 4 and 8 weeks, but it varies from patient to patient.

Painful access suddenly starts and have a duration between 10 and 45 minutes, but most often lasts between 1 and 2 hours. Attacks are triggered during patient’s relaxation periods, but painful crisis typical  start within 90 minutes of sleep, and each time occur with the same regularity in the same period of sleep, usually in REM (rapid eye movement) period. During crises, alcohol consumption, vasodilators and histamine administered subcutaneously aggravate cluster headache attacks.

The pain is severe, constant, tenacious and is described as excruciating, stabbing, sharp and lancinating. In most cases, the pain is limited to a localized area around one eye or periorbital, retroorbital, or in temporal region, accompanied by a state of agitation in which the patients do not like to lie down to rest; instead, they are restless and prefer to pace or move around. Sometimes the pain may radiate to lower half of the face,  cheek, jaw, occipital, and nuchal regions. Painful attacks are accompanied by autonomic phenomena like unilateral lacrimation, rhinorrhea or nasal obstruction, nasal congestion, conjunctival congestion, and rarely flush, nausea and vomiting. In a number of cases have been reported unilateral ptosis and miosis (small and red eye). Vegetative phenomena may occur before pain and scalp and facial skin are hyperalgal in most cases. In the episodic form of the disease attacks only occur during the activation crisis, which was observed to occur cyclically, in the same  month of the year.

Cluster Headache

Cluster Headache

Cluster Headache Treatment

Treatment in cluster headache aims a rapid control of acute attacks and prophylaxis to suppress attacks. Pain during the attack reaches a very high intensity, so oral agents are too slow to be effective. The most effective route of administration is either inhaled or intravenous one.

Prophylactic Treatment

During active period of cluster headache patients should avoid  certain substances such as alcohol or inhaling paint or oil-based solvents and exposure to altitude. Sleep attacks can be prevented by administrating 1 mg of ergotamine tartrate with one hour before badtime.

Verapamil is considered the drug of choice for pain prophylaxis and the most notable side effect is constipation. Lithium carbonate administered 2 or 3 times per day is effective in 70% -80% of cases and present as side effects gastrointestinal disturbances, tremor, confusion and weight loss.

The association between verapamil, lithium carbonate and ergotamine administered with one hour before bedtime increase the efficacy of  prophylactic treatment.

Symptomatic Treatment

Cluster attacks are aborted with sumatriptan (an agonist of 5-hydroxitriptamina). In Ekbom’s  trials, in 49% of patients attacks were aborted in 10 minutes and in 75% of patients within 15 minutes after administration of sumatriptan.

Ergotamine was widely used before the introduction of sumatriptan into cluster headache therapy. Ergotamine has a fast action administrated sublingual or inhaled. Intramuscular administration produces vomiting, although it has a fast action. The drug of choice remains dihydroergotamine, administered once or twice daily intramuscular or subcutaneous. Is as effective as sumatriptan, but may cause vomiting.

Cluster Headache

Cluster Headache

Other therapeutic options are represented by cocaine hydrochloride 5% administered intranasally, or 4% lidocaine solution, acting specifically on sfenopalatine ganglion. The disadvantages of cocaine hydrochloride administration are addiction and tachycardia.

Oxygen inhalation is considered the most effective method in aborting cluster headache crisis, 70% of attacks being aborted in 10 minutes and 90% within 20 minutes.

In the chronic form of cluster headache, without remissions, are used for prophylaxis ergotamine and methysergid. Methysergid is mainly used in cluster headache with attacks that are lasting less than three months.

Surgical Treatment

Cases of cluster headache which are refractory to medical treatment may be treated  surgical. Surgical procedures such as invasive nerve blocks and ablative neurosurgical procedures (percutaneous radiofrequency, trigeminal gangliorhizolysis, rhizotomy) all have been implemented successfully. Percutaneous radiofrequency ablation was effective  in 50% of patients and failed in about 30% of cases. Side effects include facial dysesthesia, corneal sensory loss, and anesthesia dolorosa.

Gamma-knife radiosurgery represents a less invasive procedure for cluster headache but is associated with an increased risk for facial sensory disturbances.

Deep brain stimulation with implantation of stimulating electrodes under stereotactic guidance into the ipsilateral posterior inferior hypothalamus is also a potential option for refractory cluster headache. Is an invasive procedure and is associated with significant risk of complications such as intracranial hemorrhage, subcutaneous infection, micturition syncope, and transient loss of consciousness.


Muscle Fever

Muscle fever is the result of excessive straining of the muscles that causes them to overload and get sore. Muscle fever and muscle inflammation is a common situation that is experienced by most people, at least several times during their lives. Muscle fever is defined as a sensation of discomfort or pain of the skeletal muscle after intense physical activity, usually in people who do not exercise consistently. Although muscle fever is a common condition, there is plenty of controversy about the origin, etiology and treatment.

How to treat muscle fever

Muscles that were used for exercises will experience the next day a diffuse localized pain. This symptom will worsen, especially when the muscle will be strained excessively. Muscle soreness tends to occur when the muscle is overloaded. Some scientists believe intense exercise triggers an increase in lactic acid levels, others say that the torn muscle fibers are  to blame. However, one thing is certain: after 24-72 hours after training muscle fever symptoms occur, the area becoming sore. The pain usually goes away by itself  after 3-5 days.

Muscular Fever

Muscular Fever

Fortunately there are a number of measures that can be taken in order to prevent and relieve the muscle fever symptoms:

  • Do not overload the muscles. Their strength grows and must be built gradually in order to avoid muscle fever and pain.
  • If a person ignored this advice and exercised at a high intensity, a hot bath or sauna will help. Both alternatives could help keep the situation under control, and the discomfort will be reduced.
  • Aspirin administered immediately after exercise helps eliminate the lactic acid that has formed in the muscle and prevents the ocurrence of muscle fever.

How to relieve muscle fever pain

Most people know that continuing to exercise with at a lower intensity  helps relieve the pain. This method actually works quite well. But this must be done only after the pain intensity has decreased. Although the tensioned muscle will be more painful, only when the situation seems to be under control you should start and exercise again. Otherwise, the muscles may be damaged irreparably, especially if not given the time to relax properly. Until the pain caused by the muscle fever breaks, your muscles should be relaxed with massage. There are a variety of gels that are useful for this purpose. After you start the healing process of  the muscle, some measures that you can take can prove very helpful such as consuming greater amounts of protein and carbohydrates that are designed to help rebuild it. Consumption of sugar, honey and sugar and other foods like that (bananas, watermelon, and other fresh fruit) will  also support the healing process.

If the muscle fever symptoms start to diminish, the muscle will be exercised, little by little, at a low-intensity. Even if the feeling of discomfort and pain occurs, the healing process will be much faster.


Poor Prognosis For STEMI Patients With No Reperfusion

According to researchers, advanced age is the most common cause for no reperfusion in patients with STEMI ( ST segment elevation myocardial infarction).  There are multiple reasons for no reperfusion strategy, according to an article to be published in The American Journal of Cardiology. Researchers at William Beaumont Hospital in Royal Oak, Michigan, wanted to see the reasons underlying no reperfusion strategy in patients with STEMI. They analyzed hospital admissions for a period of five years (October 2006 to March 2011) and found that of 1126 patients, 139 did not receive reperfusion. The reasons behind this choice were related disease, advanced age, late presentation, acute or chronic renal failure, dementia, etc.. Researchers have noted that by far the most common reason was age. It should be mentioned that more than half of the 139 patients were presented to the hospital with other diagnoses  than STEMI, and that nearly 30% of them had STEMI within 24 hours of admission. The researchers also noted that the prognosis was poor for these patients.

EKG Nurse

EKG Nurse

STEMI means ST-elevation myocardial infarction, that is myocardial infarction with ST segment elevation on the electrocardiogram. There is also myocardial infarction without ST segment elevation, so-called NSTEMI, which is part of acute coronary syndromes, along with unstable angina. STEMI means the death of cardiac myocytes caused by prolonged ischemia. Ischemia occurs by reducing blood flow through coronary arteries. It should be mentioned that ischemia often occurs when there is  a plaque on one of the coronary arteries. It is known that the most dangerous plaques are those rich in fat and  with thin fibrous layer. These plaques are prone to rupture and thrombosis. When such plaque ruptures, heart attack occurs. Normally, if the patient goes to the hospital quickly the clogged coronary artery (one that caused myocardial infarction) can be reperfused.However, in some cases, even if there is artery patency, myocardial reperfusion does not occur due to microvascular obstruction. This complication is called no-reflow.

There are several prognostic factors that must be taken into account in patients with STEMI, such as patient age, associated diseases, infarct size, infarct location, hypotension, others diseases. Reperfusion therapy is indicated for all patients with STEMI that go to the hospital in less than 12 hours after stroke onset. Regarding the strategy of reperfusion, there are several options: primary PCI,  percutaneous coronary intervention, fibrinolysis, delayed PCI, surgery. PCI involves mounting a stent and is preferred for all patients, especially those in cardiogenic shock or those with contraindications to fibrinolysis.


Partial Epilepsy Seizures – Clinical Presentation

Epilepsy is a chronic cerebral disorder manifested by recurrent, spontaneous seizures. An epileptic attack or a seizure represents an acute stereotype of dysfunctional motor, sensitive or sensorial behavior which is associated with loss of consciousness. Epilepsy is caused by a sudden and temporary alteration of cerebral function, due to an abnormal paroxysmal discharge of cerebral neurons caused by cortical hyperexcitability.

According to The International Classification of Seizures, epilepsy seizures are divided into partial seizures ( focal or localization-related seizures) and generalized seizures (tonic-clonic seizures and absence seizures).

Partial seizures are the result of an abnormal paroxysmal discharge of cerebral neurons within a particular brain region and they manifest focal symptoms an may progress to generalized seizures. Partial seizures are subdivided into simple partial seizures in which there is no loss of consciousness and into complex partial seizures which are always associated with loss of consciousness.



A single epilepsy seizure does not constitute a diagnosis of epilepsy, but recognizing a seizure is the first step in the workup for a possible diagnosis of epilepsy. Complex partial seizures represent the most commonly manifestation of temporal lobe epilepsy.

Partial Epilepsy Seizures

Partial or focal epilepsy seizures are divided into motor, sensory, sensorial and autonomic seizures, according to the neuronal area involved in epilepsy attack and clinical manifestation. Partial seizures may evolve to a complex partial seizure (with loss of consciousness) or to generalized epilepsy seizures.

Partial Motor Seizures

  • Motor jaksonian seizures represent the consequence of a lesion located into the ascending contralateral frontal gyrus. This seizures consist of repetitive movements or repetitive muscle contractions which may affect a body segment or may extend to the entire hemibody and include signs with or without march, versive movements and posturing.
  • Adversive seizures are the result of a lesion located into the 8th Brodman area of the frontal lobe and consist of oculocephalic deviation opposite to the focal lesion.
  • Oprecular seizures consist of hypersalvation and masitcation movements due to a lesion in the rolandic operculum.
  • Aphasic seizures characterized by receptive or expressive transient aphasia due to lesions in area 22 of the temporal lobe or in  area 44 of the frontal lobe.
  • Phonatory seizures characterized by speech blockade due to a fronto-temporal lesions.

Partial Sensory Seizures

Also known as sensory jaksonian crisis represent the consequence of a lesion located into contralateral ascending parietal gyrus. This attack consist of paresthesia which may affect only a body segment or can spread to the entire hemibody, according to the cortical somatotopy.

Partial Epilepsy Seizures

Partial Epilepsy Seizures

Partial Sensorial Seizures

  • Visual crisis caused by lesions manly located in the occipital lobe, but with possibility of extension to parietal or temporal lobes. Visual crisis may be represented by an illusional crisis with a distorted perception of space and surrounding objects, or may be represented by hallucinatory crisis. This hallucinatory crisis are simple, with geometrical scintillations in controlateral visual field, and complex with figurative perception or with lack of recognition of surrounding objects and family members or friends.
  • Auditory crisis   generally related to the temporal lobe lesions, are represented by auditory illusions with perception of distorted sound or by auditory hallucinations with perception of elementary or complex sounds (voices, music) or with lack of recognition of familiar sounds.

Partial Autonomic Seizures (Autonomic Crisis)

Are the result of lesions located in the frontal lobe, hypothalamus, basal ganglia, temporal lobe and are represented by paroxysmal hyperhydrosis (abnormally increased perspiration), respiratory crisis (paroxysmal hyperpneea), paroxysmal hyperthermia, hypertension crisis or vagal crisis (bradycardia, hypotension, pallor and dyspneea).

Temporal Lobe Partial Seizures

Temporal lobe epilepsy is the result of chronic lesions localized in the medial portion and the hippocampal region of temporal lobe. A link between febrile condition in childhood and temporal lobe epilepsy has been suggested, but the exact role of febrile conditions remains unknown. Some studies suggested that human herpesvirus-6 represents the link between febrile conditions in childhood and later development of temporal epilepsy.

Temporal lobe partial seizures are divided into pyschosensorial crisis and pyschomotor crisis.

Psychosensorial crisis consist of olphactive and taste hallucinations along with affective symptoms such as sensation of intense happiness, fear and anxiety and cognitive symptoms such as sensations of familiarity ( déjà vu, déjà vecu) or sensations of estrangement (jamais vu, jamais vecu).

Temporal Epilepsy

Temporal Epilepsy

Psychomotor crisis are accompanied by impairment of consciousness and represented by:

  • Minor automatism crisis are characterized by impaired consciousness associated with motor automatisms (dressing movements, automatic movements of hands and mouth), verbal automatisms (repetition of one word, of a sentence or a phrase) and gelastic automatisms (laughing accesses).
  • Major automatism crisis are characterized by an important loss of consciousness and more complex motor behavior. In this type of crisis patients may walk into different places and sometimes may commit violent acts of which they don’t remember after the crisis.


New Study Finds Promising Treatment Improvement for Prostate Cancer

One of the treatment methods of prostate cancer involves the use of radiotherapy. In order for the radiotherapy to be successful, the accurate position of the tumor must be known. This allows the radiation to avoid irradiation of the healthy tissue surrounding the cancerous tissue. A new study led by professor Paul Keall and his team from the University of Sydney managed to accurately pinpoint the location of prostate tumors within 0.5 mm.

The new prostate cancer technique, called KIM (Kilovoltage Intrafraction Monitoring), was used on a group of 10 patients. The method uses X-rays in order to accurately measure the position of markers previously implanted in the prostate through a new calculation method that uses 2D and 3D imaging.

This technology was first developed in 2008, at Stanford University, by professor Paul Keall and professor Per Poulsen. The current study is conducted through the collaboration of the University of Sydney, Aarhus University from Denmark and the Royal North Shore Hospital.

According to the results of the study, an overall accuracy of over 0.5 mm has been achieved. These results indicate that the new technology is more accurate than other commercial systems that monitor prostate cancer. Another advantage offered by the Kilovoltage Intrafraction Monitoring system is the predicted low-cost of the routine. This is achieved through the use of readily available radiation therapy equipment.

Prostate Cancer

Prostate Cancer

“KIM is exciting for patients because it’s going to open up a new area of radiation oncology, real-time tumor tracking,  but, it could potentially be available to all cancer radiotherapy patients that are treated using standard machines”, said Dr Thomas Eade, one of the radiation oncologists at the Royal North Shore Hospital.

A small amount of imaging dose is added through the use of the Kilovoltage Intrafraction Monitoring system X-rays. Professor Keall notes that further improvement in the accuracy of the system is possible with an even lower imaging does. He added that the current system has been implemented within several constrains, such as an existing clinical cancer radiotherapy system. According to the research team, there are already new ideas to increase the accuracy of the system.

The plans for the near future are to use the information provided by KIM to pause and adjust the radiation beam used in radiotherapy when the prostate cancer position changes. The ultimate plan of the research team is to be able to use the information gathered through the KIM system to continuously align the radiation beam without having to pause the treatment.